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SAN JOAQUi. .:OUNTY ENVIRONMENTAL HEALTF.-EPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 3/11/2015 <br />Submitted on: 1/15/2015 3:14:59PM CERS ID: 10185571 <br />Submitted by: Anthony Enos Email: pdoxilvr@gmail.com Facility ID in CERS: FA0016887 <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />OW0013728 <br />ABA FARMS <br />16505 S TRACY BLVD <br />TRACY, CA 95304 <br />209-835-0406 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0016887 <br />Facility name <br />ABA FARMS <br />Site address <br />9447 HOWARD RD <br />City <br />STOCKTON <br />ZIP code <br />95206 <br />Facility phone <br />209-835-0406 <br />Facility mailing address 16505 S TRACY BLVD <br />TRACY, CA 95304 <br />BILLING INFORMATION <br />Contact name ABA FARMS <br />Address 16505 TRACY BLVD <br />STOCKTON, CA 95206 <br />Contact phone 209-835-0406 <br />Contact email <br />Mail invoices to �0" <br />Information after CIW processing CERS <br />(current submittal) field <br />ABA FARMS 111 <br />16505 S TRACY BLVD 113 <br />TRACY, CA 95304 114, 115, 116 <br />209-835-0406 112 <br />ABA FARMS <br />3 <br />9447 HOWARD RD <br />103 <br />STOCKTON <br />104 <br />95206 <br />105 <br />(209) 835-0406 0 <br />102 <br />16505 S TRACY BLVD <br />108a <br />TRACY, CA 95304 <br />108b, 108c,108d <br />ABA FARMS 140 <br />16505 TRACY BLVD 143 <br />STOCKTON, CA 95206 144, 145, 146 <br />209-835-0406 141 <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: _ <br />New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: OV'n Date: <br />Accounting: Reviewed by: �It(— Date: 3 ]�� Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status Reactivated Inactivated <br />1958 - HM -Farm Operations PR0525072 ROBERT LOPEZ Active [ ] [ ] <br />2830 - AST FAC - SPCC EXEMPT PR0530352 THUY TRAN Active <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0531856 not assigned Inactive [ ] [ ] <br />